Septic Thrombophlebitis

Not surprisingly, this clinical entity is similar in many ways to both deep vein thrombosis and bacteremia.

Most common sites include: pelvis in association with C-section, IJ in association with infections of head/neck, portal vein related to intrabdominal infections such as diverticulitis or appendicitis, and the veins of the upper limbs in association with indwelling central catheters

Treatment involves medical therapy with intravenous antibiotics and often heparin (review here). Surgical intervention or thrombolysis are reserved for refractory cases. Treatment duration variable.

• In uncomplicated cases, with limited superficial vein involvement, and negative blood cultures, treatment can be as short as 48h past clinical stability, normalization of the white count, and defervessence.
• In other cases with bacteremia and/or metastatic spread treatment duration will range 2-6 weeks.

This article reviews Lemierre's syndrome (also see orignial article from 1936) -- Septic thrombophlebitis of the internal jugular vein with associated Fusobacterium necrophorum septicemia and metastatic infection.